How Does It Work?

Third-degree burns destroy both the inner and outer layers of the skin. The traditional treatment for these injuries are skin grafts, which are pieces of healthy skin harvested from an unaffected area of the body that are used to cover the wound. But in situations where burns are especially severe and cover the entire body, there isn't always enough healthy skin available to cover the damaged area. Enter WFIRM's 3D bioprinter.

The device "print[s] skin cells onto burn wounds," but the so-called ink is actually made up of healthy skin cells, according to a WFIRM press release. "A scanner is used to determine wound size and depth. Different kinds of skin cells are found at different depths. This data guides the printer as it applies layers of the correct type of cells to cover the wound. You only need a patch of skin one-tenth the size of the burn to grow enough skin cells for skin printing."

So far, clinical trials of this printer on mice and pigs have been successful in healing wounds. "WFIRM research has shown that burn wounds healed in three weeks with bioprinting compared to five weeks for standard burn treatment," John D. Jackson, Ph.D., Associate Professor at WFIRM tells Curiosity. "Research has shown that the longer it takes to cover a wound with skin, the higher the risk of infection, complications, and death."

Still, it's unclear when the technology will be available for patients. "The skin bioprinting project is still in the development stage," Jacskon says. "This technology looks very promising, but it is difficult to predict how quickly it will progress and be ready for humans. It will need to be tested further and refined before it is ready for patients."

A First Step

The printer is part one of WFIRM's efforts to help military troops wounded on the battlefield with their advances in regenerative medicine. In 2006, Lake Forest scientists were the first in the world to successfully implant laboratory grown organs into humans, when they implanted bladders grown from a patients' own cells. In 2013, WFIRM was chosen to lead the charge of the second phase of the Armed Forces Institute of Regenerative Medicine (AFIRM), which is a "five-year, $75 million federally funded project focus[ing] on applying regenerative medicine to battlefield injuries," according to a WFIRM press release. One of the main focal points of AFIRM is skin regeneration for burn injuries of soldiers wounded in battle. Next, "the WFIRM team will explore whether a type of stem cell found in amniotic fluid and placenta (afterbirth) is effective at healing wounds."

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Expert Insight

John D. Jackson, Ph.D.

Associate Professor, Wake Forest Institute for Regenerative Medicine

Q:

How does bioprinting work?

A:

Bioprinting is an adaptation of various printing techniques for the creation of biological constructs. In the current project to print skin cells on burn wounds, a laser scans the wound to determine the size and depth, creating a "map" of the wound. A computer then controls the release of cells from the reservoirs into the print head, where they are delivered directly on the burn. The wound map is used as a guide so that the correct type and number of cells can be precisely placed on the wound.

Q:

Why is this advancement so important for use with wounded soldiers?

A:

Burn injury is a common cause of mortality in the battlefield, comprising 10 to 30 percent of all casualties. Skin is the body's largest organ and is very important because it is a barrier to infection and prevents the body from losing water and heat. Current treatment options are unable to fully address the needs of combat burn care. Substitute skin products are available, but they are limited in size and some require a lengthy preparation time. With traditional skin grafts, many burn patients don't have enough unburned skin to harvest grafts. A new approach is needed to immediately stabilize the wound and promote healing.

Q:

What are the implications of this new technology?

A:

If the technology is successful, its benefits will be to quickly cover a burn wound and promote healing. It would build skin in place, rather than having to surgically move skin from one part of the body to another. And, while this treatment will first be tested in new burns, it's possible that it could also be used to treat scarring from previous burns -- by removing the scarred tissue and rebuilding skin. In addition, it might be considered as a treatment for skin ulcers in patients with diabetes.